97例中央型肺癌纤支镜检查分析

９７例中央型肺癌纤支镜检查分析叶向阳临床资料选择我院１９８７年至１９９１年间经纤支镜检查并病理确诊的中央型肺癌９７例进行分析。一、性别与年龄：男８６例，女１１例，最小年龄２６岁，最大年龄７７岁，平均５５．９６岁。仅３例低于４０岁，４０岁以上９４例占９...     

老年人纤支镜检查中缺氧的纠正

老年患者心肺脑肾等功能有不同程度减退，进行纤支镜检查时易出现缺氧表现。为了纠正纤支镜检查中的缺氧，诈者对52例60岁以上老年患者作纤支镜检查和治疗时分别应用普通鼻塞给氧和高频通气给氧进行比较，观察纤支镜检查中的缺氧纠正情况，现报告如下。1临床资料1．1对象对52例临床上需要进行纤支镜检查和治疗的老年患者随机分普通给氧组（25例），男15例，女10例；高频通气给氧组（27例），男16例，女11例。同组间采用自身对照，两组间采用实验对照。1．2方法接受纤支镜检查前作心电图检查，并统一用美国（IL公司）1321型血气分析仪进行血…     

经纤支镜检查77例临床资料分析

目的 探讨纤支镜应用的临床价值.方法回顾分析2007年2月至2012年4月经纤支镜检查的病例资料.结果 确诊肺癌61例,其中多数为鳞癌,28/61例,气管错构瘤1例,内膜结核2例,肺炎9例,肺脓肿2例,气管内异物2例.结论 纤支镜应用于临床,不仅可早期发现、诊断肺癌,为治疗提供依据,而且结合镜下治疗,可缓解气道阻塞或行肺泡灌洗术治疗肺脓肿,疗效较好,临床应用价值较高.     

纤支镜检确诊肺癌与肺结核致肺不张临床分析

目的 通过纤支镜检肺不张患者,提高早期肺癌和肺结核诊断。方法 收集我院2000年1月～2007年1月门诊与住院的肺不张患者100例进行临床观察与纤支镜检。结果 肺癌与肺结核引起肺不张患者临床表现多样,纤支镜下肺癌新生物鲜嫩组织脆性大呈现菜花、息肉、桑椹、糜烂等表现。支气管内膜结核可见黏膜肥厚、粗糙、溃疡、肉芽、干酪坏死及瘢痕样改变。结论 纤支镜检可早期诊断肺癌和肺结核引起肺不张。     

纤支镜检查对704例70岁以上疑似肺癌患者的诊断价值与安全性

目的回顾性分析纤支镜检查对>70岁疑似肺癌患的诊断价值与安全性．方法704例x线鞠片异常疑似肺癌施行纤支镜检查，术前常规做出凝血时间、心电图、动脉血气分析，异常术中予以吸氧及心电监护。采取改良贾克森氏喷雾法及术中分段喷雾麻醉．术中发现病变做刷检、钳检、冲洗物等检查．结果704例中484例确诊为肺癌．其中鳞癌290例、腺癌123例、小细胞癌35例、鳞腺混合癌9例、未定型27例．62例心电图有ST—T波改变及18例氧分压50mmHg经吸氧后氧分压升至70mmHg再施术．均末发现有明显不良反应。结论纤支镜检查对>70岁患是安全的，对疑似肺癌有较大的诊断价值．     

21例继发性肺曲菌病纤支镜所见与病理分析

对Ｘ线秀丽不典型的２１例继发性肺曲菌病，进行纤支镜检查及病理分析，认为纤支镜检查对于提高该病的诊断率有很大的帮助。     

154例肺不张纤支镜检查结果分析

我院从1985年至1993年底对154例原因不明的肺不张进行了纤支镜检查,现对其检查结果作如下分析。 临床资料 1.一般资料:本组共154例,男104例,女50例。最大年龄77岁,最小年龄16例,平均年龄52岁。 2.X线和纤支镜检查结果:见表。     

经纤支镜针吸活检对肺癌的诊断价值

经纤支镜针吸活检对肺癌的诊断价值新汶矿务局中心医院（２７１２３３）孙启洪为了进一步提高纤维支气管镜（纤支镜）对肺癌诊断的阳性率，我们在行钳检和刷检的同时采用针吸活检（针吸），阳性率明显提高。现将８３例肺癌患者的检查结果报告如下。１资料与方法１．１本组...     

重复纤支镜检查的诊断价值

通过对1996年11月—2002年9月行重复纤支镜检查(RFB)者45例的临床资料分析，探讨RFB的诊断价值及其指征。结果：明确诊断者35例，占77．78％。表明RFB提高了肺部疾病的诊断价值，尤其当首次纤支镜检查无阳性结果而临床高度怀疑肺癌、镜下见到新生物样改变或咯血原因不明者应予RFB。     

纤支镜检查发现左肺舌叶畸胎瘤1例

临床资料 患者男,37岁,因“反复咳嗽、咳痰、咯血2年,复发1个月余”入院。入院前2年无明显诱因出现咳嗽、咳痰、咯血,痰量少、为黄色黏稠状,不易咳出、有腥臭味,咯血每日量约10ml、呈满口鲜血。到当地医院就诊,胸片提示左上叶炎症,给于抗感染、止血、对症治疗（具体用药不详）后,咯血缓解,咳嗽、咳痰好转。后上述症状反复出现,     

肺癌患者肺炎衣原体感染的研究

目的 为了探索肺炎衣原体(Cpn)和肺癌的关系。方法 应用聚合酶链反应（PCR）和血清间接微量免疫荧光试验（MIF）检测肺癌80例,非肺癌基础肺病80例痰中Cpn DNA和血清中抗Cpn IgM、IgG抗体。结果 肺癌组Cpn急性感染率（42．5％）和慢性感染率（86％）均明显高于非肺癌肺病组（8．8％;71％）,肺癌合并Cpn急性感染者,除肺部罗音,胸片渗出性病变出现较高外,其他临床表现与无Cpn急性感染的肺癌无不同。结论 PCR是检测Cpn的有用方法,肺癌患者易患Cpn感染,Cpn感染与肺癌有一定的关系,值得临床重视。     

老年肺癌的诊治

目的对65岁以上肺癌患者进行回顾性分析。方法自1994至2003年,我们共统计934例肺癌手术病人,其中65岁以上患者共355例,占38%,手术切除率为98.6%。结果平均年龄71.4±5岁(65～81岁),其中男性293例(82.5%),女性62例(17.5%)。手术包括:全肺切除26例,肺叶切除(包括双叶切除)286例,袖状切除27例,隆凸切除术5例,电视胸腔镜辅助下楔形切除6例,剖胸探查5例。术后病理为鳞癌185例,腺癌133例,大细胞癌17例,小细胞肺癌6例,其余的占14例。Ⅰ期26例,Ⅱ期6例,Ⅲ期323例。结论常规胸片检查可作为早期高危人群中检测肺癌的手段之一。虽然老年患者术后伴有高风险并发症,但手术仍然是治疗非小细胞肺癌(Ⅰ￣Ⅲ期)的主要手段,年龄并非是一个有意义的预后因素。本组病人中合并COPD者占37.6%。如病人的FEV1>1.6L或Vo2max>10ml/kg·min或能登上三楼(11米高),手术是安全的。总之,老年患者严格掌握手术适应证和做好术前准备,其手术并发症未显著增高。以手术为主的综合治疗能有效提高老年肺癌患者的生存期。     

A CASE OF PEDUNCULATED POLYPOID CANCER ASSOCIATED WITH FLAT‐TYPE CANCER OF THE GALLBLADDER

Pedunculated polypoid cancer of the gallbladder ordinarily shows cancer spread within the polyp consisting mainly of adenoma. We experienced a case of pedunculated mucosal cancer associated with flat‐type cancer of the gallbladder without an adenomatous component, the details of which are reported herein. The lesion was first detected by transabdominal ultrasonography (US) as a polypoid lesion of the gallbladder, 5 mm in size. Distinct growth of the lesion was revealed at follow‐up US after a year. Endoscopic ultrasonography showed not only a pedunculated polypoid lesion, 9 mm in size, with a solid internal echo pattern and a nodular surface, but also slight thickening of the surrounding gallbladder wall. Cholecystectomy was performed with a preoperative diagnosis of early gallbladder cancer, and a pedunculated polypoid lesion, 8 × 8 × 3 mm in size with a thin stalk and a nodular contour, surrounded by a widely spreading flat lesion with a coarse‐granular surface, was confirmed. Microscopically, the stalk was 700 µm in size, and both the pedunculated polypoid lesion and flat lesion consisted of well‐differentiated tubular adenocarcinoma limited to the mucosa, without an adenomatous component.     

纤支镜活刷检标本DNA含量的流式细胞仪分析

本文采用纤维支气管镜（纤支镜）技术，对２６例中心型支气管肺癌（肺癌）进行活检和刷检，并将活检和刷检标本制成单细胞悬液，用流式细胞仪测定其ＤＮＡ含量。结果提示，新鲜肺癌组织中异倍体检出率明显增加，异倍体的出现多与恶性肿瘤存在有关。本文认为，行纤支镜活检和刷检中的任何一项检查，多可获得阳性结果；与活检比，刷检操作更简便，对组织损伤小，出血和并发症少，可弥补管壁浸润型肺癌不易获得活检标本之不足，具有相当大的实用价值。     

A CASE OF DIFFUSE‐TYPE EARLY GASTRIC CANCER WITH NODULAR GASTRITIS

A 39‐year‐old woman was referred to Osaka Police Hospital and admitted for surgical treatment of gastric cancer. Barium upper gastrointestinal study and endoscopic examination showed a 3.0 × 3.0 cm depressed lesion in the greater curvature of the middle corpus. An unusual miliary pattern resembling ‘goose flesh’ was observed endoscopically in the antrum. Biopsy specimens from the tumor showed poorly differentiated adenocarcinoma, and specimens from the antrum showed many lymphoid follicles with a germinal center. Rapid urease test and histological tests (Giemsa stain) for Helicobacter pylori were both positive. Early gastric cancer with nodular gastritis (NG) was diagnosed and a partial gastrectomy was performed. Histological examination of the resected specimen showed a stage I tumor consisting mainly of signet‐ring cell carcinoma restricted to the mucosa. Postoperatively H. pylori eradication therapy was performed and proved to be successful. One year after eradication therapy, endoscopy with biopsy showed no recurrence of gastric cancer and the remarkable regression of antral NG.     

肺癌雌孕激素受体测定与临床病理研究

目的 运用蜡切片、免疫组化标记对146例各种组织学类型的原发性支气管肺癌进行雌孕激素受体水平检测,结果:ER阳性检出率58.9％,PR阳性检出率69.1％,双阳性46.6％。雌孕激素受休阳性率除与肿瘤分化程度呈正相关外,与组织学类型、肿块大小、患者年龄、性别无关。     

EX VIVO CASE STUDY OF ENDOCYTOSCOPY IN SUPERFICIAL ESOPHAGEAL CANCER

Microscopic observation at the cellular level using endocytoscopy was obtained in surface mucosa of the gastrointestinal tract. This paper describes ex vivo images for endoscopically resected specimens of superficial esophageal cancer using endocytoscopy with methylene blue staining. The endocytoscopy images of cancerous and non‐cancerous sites corresponded generally with horizontal histological images. The pattern of the cellular arrangement and the size and shape of cells were similar between endocytoscopy and horizontal histological imaging. Endocytoscopy is an effective tool for diagnosis of esophageal cancer.     

肺癌早期诊断的临床进展

肺癌是发病率及病死率增长最为迅速的恶性肿瘤,已成为威胁人类健康和癌症死亡主要病因之一。肺癌5年生存率13％～15％,早期诊断率仅15％。提高肺癌的早期诊断是改善肺癌5年生存率的关键。整合影像学方法和微创检查技术,同时开展痰细胞学检查、血清肿瘤标记物测定对提高肺癌的早期诊断具有临床意义。本文回顾影像学诊断方法、痰细胞学检查、微创介入诊断技术临床应用,以及近年来国外开展的肺癌诊断技术的临床进展。     

RETROSPECTIVE STUDY OF ENDOSCOPIC FINDINGS: 250 CASES OF GASTRIC CANCER

Background : The accuracy of endoscopy for detecting gastric cancer is high but failures may occur if the cancer is not visualized or recognized with gastroscopy. The aim of this study was to understand the reasons why gastroscopy may not detect gastric cancer. Methods : Patients with gastric cancer (n = 4053) diagnosed between 1979 and 1996 were studied by linking gastroscopic examinations (n = 111 094). Endoscopic records were reviewed in 250 patients who were diagnosed with gastric cancer but had not been diagnosed as such on the examination within the previous 3 years. Results : In 33 patients (13.2%) gastric cancer was detected at the advanced stage. The percentage of advanced cancer was significantly higher on the cardia and the gastric body than it was on the angulus and the antrum. In 107 patients (42.8%) no lesion was identified after reviewing endoscopic records. In 102 patients (40.8%) marked lesions were present but had not been diagnosed as such. In 41 patients (16.4%) gastric cancer may have been overlooked but due to a lack of photographic documentation in the specific areas, these findings were not confirmed. The percentage of the indeterminate examinations was significantly higher in lesions on the remnant stomach and the cardia than in other areas. Conclusion : In order to reduce the proportion of the advanced gastric cancer to under 20%, repeated endoscopic examinations were recommended within 2 years even if any suspicious lesions could not be detected by the initial examination.